Oral Mucosa GN.pdf

Oral Mucosa [Oral and Dental Sciences] Miss H Rogers GDC ILOs 1.1.5 Describe relevant and appropriate dental, oral, craniofacial and general anatomy and explain their applica;on to pa;ent management 1.1.6 Describe relevant and appropriate physiology and explain its applica;on to pa;ent management...

Oral Mucosa [Oral and Dental Sciences] Miss H Rogers GDC ILOs 1.1.5 Describe relevant and appropriate dental, oral, craniofacial and general anatomy and explain their applica;on to pa;ent management 1.1.6 Describe relevant and appropriate physiology and explain its applica;on to pa;ent management Related topics  Epithelium  Connec;ve Tissue  Intra-oral examina;on 3 Aim To gain an overview of the structure and func;on of the oral mucosa Learning Outcomes By the end of this lecture you should be able to: 1.Describe the diEerent types of mucosa and their histopathology in health 2.Iden;fy the areas of the oral cavity each type of mucosa is associated with 3.Iden;fy changes in the appearance of the oral mucosa 4 lines oral mucous membrane that Cavity. What is it? What do you understand by the term oral mucosa?  Barrier from infections protecting underly tissues - and organs (mechanical forces. , · Barrier protects from Surface abrasions Saliva from minor ·. · saliva grands-lubrication · Helps reduce trauma Sensory ↑ -receptors : · temperature pain · touch protective · reflexes ; swallowing or gagging. 6 Stratified Squamous epithelium. A Structure Connective tissue - 7 Have a look at your mouth in the mirror: What does the mucosa look like? How would you describe it- smooth/rough, pink/red, Nrm/soO? Does the appearance change depending on the area? 8 ClassiAcaBon Based on their histological features, the oral mucosa can be divided into three main types: Lining mucosa Mas;catory mucosa Specialised mucosa Lining Mucosa 9 1 0 The structures covered by lining mucosa include: Can you iden;fy these areas in your own mouth? How would you describe the appearance of these areas? 1 1 In health, the lining mucosa’s clinical appearance generally - has: A soOer surface texture A moist surface An ability to be stretched and compressed (ac;ng like a cushion for the underlying structures) - - 1 2 · fordyce spots - normed appearance elevations on oral mucosa surface. - small yellowish ↑ Sebum from misplaced deposits of caused by - sebaceous glands Do not ↳ found in need further submucosa. investigation. 1 3 Histology Think back to what you’ve learnt on epithelium… Can you remember the three types stra;Ned squamous epithelium? Out of these three, and based on what you could see, which do you think is most associated with the lining mucosa? Why? 1 4 oral cavity. -most common in Answer: NonkeraBnised stratified Squamous fewer and Large layer of · less pronounced submucosa. - and refe ridges allows for Connective tissue & compression papille. of underlying · more elastic. tissues fibres & ↳ aids with speech + swallowing. - 1 5 AddiBonal features Lining mucosa. Surgical incisions in these areas oOen requires sutures Local anaesthe;c injec;ons are easier in these areas with less discomfort. Infec;on can spread rapidly Why do you think these may be? MasBcatory Mucosa 16 1 7 The structures covered by mas;catory mucosa include: Can you iden;fy these areas in your own mouth? How would you describe the appearance of these areas? - Keratinized 1 8 In health, the mas;catory mucosa’s clinical appearance generally has: Rubbery surface texture Resiliency (Nrm base) no movement 1 rete ridges 9 more Histology - ↳ gives mucosa a firmer base · Bore unoulies SUBMUCOSA. Which do you think is most associated with the mas;catory mucosa, thin or not very S 3 nonkera;nised or kera;nised epithelium? Why? present - not present in Aids with function attached gingiva. for hard surfaces Seating , Speaking. least common Hard palate attached- tongue part of : · + , Dorsum of gingiva attache gingiva. 2 0 Addi;onal features masticatory > - mucosa. Sutures are rarely needed in these areas following surgical procedures Local anaesthe;c injec;ons are more di\cult and cause more discomfort Swellings in these ;ssues caused by infec;ons cause greater discomfort Why do you think these may be? Harder surface underlined by bone. Specialised Mucosa 21 2 2 The structures associated with specialised mucosa include: Bumps on dorsal and lingual surfaces of tongue. 2 3 Which do you think is most associated with the specialised mucosa, nonkera;nised or kera;nised epithelium? Why? either of or tho parce or cell turnover times - Junctional epithelium-4-6 days - Hard 24 palate days. - nonkeratinized buccal mucosa turns over faster times than Keratinized attacked gingiva.  Variations Changes in appearance: Hyperkera1nisa1on 24 2 5 Nonkera(nised epithelium may transform into a kera(nising type in response to fric(onal or chemical trauma. It has therefore become- hyperkera1nised. Histologically the (ssue will resemble orthokera(nised epithelium with a kera(n and granular layer Can be reversible but takes time. can also occur in Keratinized epitheliom. 2 6 Hard palate 1. Can you iden(fy the hyperkera(nised area? 2. How would you describe this area? small whitish Irregular red , 3. Which type of mucosa has with it occurred on? masticatory area & border hard palate , adj. ULS67. mucosa 4. What do you think the possible cause may be and why? trauma-heat-food drink. or Ulcerated Keratinized area. 2 7 sulcus buccal - 1. Can you iden(fy the hyperkera(nised area? 2. How would you describe this area?uneven Keratinization Strictions in buccal mucosa 3. Which type of mucosa has it occurred on? lining Muncosa 4. What do you think the possible cause may be and why? Chemical trauma. Caspirin) 2 8 White line along buccal mucosa & consistent with teeth meeting in lining - occlusion' mucosa lines - positioned- Alber 1. Can you iden(fy the between hyperkera(nised area? occuesal places 2. How would you describe this area? 3. Which type of mucosa has it occurred on? a masticator - 4. What do you think the possible cause may be and why? occlusion causing friction Mandibuna. friction from /p/ Changes in appearance: Oral Pigmenta1on 29 3 0 neural crest Oral pigmentation metanine-formed by melanocyte originate from. - · Sit in basal layer between dividing epithelia cells. is stored and · melanocytes have cytoplasmic granwel-melanine injected into newly formed epithelial cells. 3 1 As the (ssue ages, these epithelial cells migrate to the surface of the oral mucosa and appear as localised Eat pigmented areas, ranging from brown to brownish-black 3 2 Other colour changes may also occur to the oral mucosa, some of which may be covered in more detail in Dental Speciali(es in Year 2. Here are a few examples… 3 3 other medication Drug Induced including : · tetracycline Chemotherapy 3 4 with Kaposi sarcoma lesions associated ↑ Infec1on progression of HIV to aids. 3 5 Amalgam tattoo from possible trauma · : Iatrogenic at time of restoration placement. damage 3 6 tatoos Self-in@icted > - 3 7 Addi1onal resources YouTube Dental Educa(on Hub- Oral Mucosa Playlist hQps://www.youtube.com/playlist?list=PLjIUkW-fumBz9qmi_ 3pw_5uWVN6Rt-tb_ Website Geeky Medics- Pigmented lesions of the oral cavity hQps://geekymedics.com/pigmented-lesions-of-the-oral-cavi ty / 3 8 References Bath-Balogh, M. & Fehrenbach, M.J. Dental Embryology, Histology, and Anatomy. Elsevier 2006. Royal Berkshire NHS Founda(on Trust. Oral fric8onal hyperkeratosis (May 2022). Available at: hQps://www.royalberkshire.nhs.uk/media/jt0fzg2w/oral-fric (onal-hyperkeratosis-i-_may22.pdf [Accessed 26th September 2022].